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Study backs HPV vaccine for boys

Vaccinating boys against the human papillomavirus could help reduce throat cancers and save millions, says study in journal Cancer.

Lillian Siu, an oncologist at the Princess Margaret Cancer Centre, is co-author of a paper saying it would make financial sense to vaccinate boys against HPV.

Mon., April 13, 2015

Vaccinating boys against the virus that causes cervical cancer in women could help stave off a growing threat of throat tumours in men and save the country’s health-care system millions of dollars a year, a new study suggest.

Throat cancers related to the human papillomavirus (HPV) afflict about three times as many men as women and their total numbers could overtake those of cervical cancers within a decade, one of the study’s Toronto authors says.

“The interpretation is that oropharyngeal (throat) cancer will become the most common (HPV) related cancer … surpassing cervical cancer,” says Dr. Lillian Siu, an oncologist at the Princess Margaret Cancer Centre.

Some 1,450 women will develop cervical cancer each year in Canada and about 380 will die of the disease.

“Certainly in the developed world, North America and Western Europe we’re seeing more and more of HPV-positive oropharyngial cancer,” Siu says.

Such cancers affect the tonsil area and the base of the tongue and are strongly related to the sexually transmitted virus.

Incidence of the disease has been growing among men, but the reason it affects males more than females is unclear, Siu says. Her study — being released Monday April 13 by the journal Cancer — projects Canada’s health system could reap between $8 million and $28 million in annual savings by making the vaccine freely available to boys.

Currently, the vaccine — given in a series of three shots over six months — is covered by provincial health plans across the country for girls only. Nova Scotia, however, announced in its budget last week that it will begin offering the vaccine to boys in Grade 7 during the next school year.

But the costs of making the $400 vaccine series available to Grade 8 boys would be more than offset by the savings found in not having to treat future cancers, Siu says.

She admits, however, that these savings would not be realized for decades, as the disease typically develops between the ages of 40 and 70.

The vaccine has also proven controversial in some conservative circles where it’s seen as promoting or condoning greater sexual permissiveness among teenagers and young adults.

There is no reason to deny the shots to boys right now, says Kelly Gorman, senior manager of public issues for the Canadian Cancer Society’s Ontario division.

“It’s providing as much protection to as many people as possible in terms of preventing cancer and reducing the burden of cancer on society,” Gorman says.

Gorman also says vaccine costs could soon drop with new drugs coming online and studies showing that two doses of the current shots likely offer sufficient protection. The society also says the vaccines, which include Gardasil, have proven both safe and effective in women.

Siu’s study looked at the 192,000 Canadian boys who were 12 years old in 2012. It used statistical modelling to project the number of them likely to get the vaccine and the decrease in future cancers that would result.

Currently about 50 to 80 per cent of Canadian girls opt to receive the HPV shots, depending on the province, and vaccinating men would also add to the so called “herd protection” across the entire population, Siu says.

“If we do start vaccinating men and they have sex with women there will be a herd immunity effect in the opposite direction,” she says.

The move would also reduce the incidence of anal cancers and other rectal diseases, Siu says.

“I think I’m naive to think a theoretical model will change government policy, but I think raising awareness is important,” Siu said of the paper.

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